Use of a revision cup for treatment of Zurich cementless acetabular cup loosening

2013 ◽  
Vol 26 (05) ◽  
pp. 408-415 ◽  
Author(s):  
L. Vezzoni ◽  
V. Montinaro ◽  
A. Vezzoni
Keyword(s):  
Postoperative Complications ◽  
Clinical Results ◽  
Variable Number ◽  
Outer Shell ◽  
Acetabular Cup ◽  
Press Fit ◽  
Titanium Screws ◽  
Successful Clinical Outcome ◽  
Hip Luxation

SummaryLoosening of the acetabular cup is one of the most common complications following total hip replacement and has an incidence rate of 1.8% to 36.8%. The objective of this study was to describe the surgical technique for the application of a cementless acetabular component specifically designed for treatment of cup loosening and preliminary clinical experience. The Kyon revision cup is composed of two components; the first is a perforated titanium outer shell with holes for 2.4 mm titanium screws, which is impacted into the acetabulum after removal of the loose cup and reaming of the acetabulum. It is secured with a variable number of screws. The second component is an inner plain titanium cup with an ultra-high-molecular-weight polyethylene insert, which is impacted into the outer shell to obtain press-fit stability. This revision cup was used in 31 dogs with cup loosening and a minimum follow-up period of six months. There were four intra-operative complications and two postoperative complications. The main intra-operative complication was difficulty inserting the inner cup into the outer shell. Postoperative complications included craniodorsal hip luxation in one dog, which was successfully managed, and cup loosening in another dog, which required explantation of the prosthesis. The main advantage of the revision cup appears to be increased implant stability afforded by screw fixation. Our initial clinical results in 31 dogs were promising; all but one dog had a successful clinical outcome.

Noncemented Hip Replacement using a Conical Screw-In Cup and a Straight Press-Fit Stem. A Six to Eight-Year Clinical and Radiological follow-up Study

1998 ◽  
Vol 8 (4) ◽  
pp. 208-218 ◽  
Author(s):  
G. Köster ◽  
S. Leib ◽  
H.-G. Willert
Keyword(s):  
Hip Replacement ◽  
Clinical Symptoms ◽  
Bone Ingrowth ◽  
Control Period ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Radiographic Appearance ◽  
Press Fit ◽  
Bone Atrophy

Noncemented hip replacement using a conical titanium metal-backed screw-in cup to be implanted with precutting of the threads (TITAN-METAL-BACKED, AlloPro, Baar, Switzerland), in combination with a straight conical press-fit stem (Zweymüller-“hochgezogen”, AlloPro, Baar, Switzerland) was evaluated clinically and radiologically in 64 consecutive primary arthroplasties with an average 7.2 year follow-up. The clinical results compare very favourably with other cementless systems. The Harris hip score revealed an improvement from 45 to 84. The Merle d'Aubigné index showed an increase during the case-control period from 16 to 26. Thigh pain was practically absent except in one patient. A radiographic appearance of bone ingrowth around the acetabular component was found in nearly all cases. Only one cup migrated in a patient with a large cystic lesion in the acetabular roof, which was not grafted, with no other signs of loosening. Additionally this patient had chemotherapy. In all other cases there were no signs of cup migration, significant radiolucency, osteolysis or definite cup loosening. Around the stem, primary cortical contact was mainly located in the distal zones. Radiolucent lines appeared only proximally, with few exceptions, and were, except in four cases, always smaller than 2 mm. They were never circumferential and usually combined with sclerotic lines. Only one stem subsided, but the patient remained asymptomatic. There was a high incidence of proximal bone atrophy, distal cortical thickening and endosteal bone formation, not correlating with radiological loosening or clinical symptoms. Signs of femoral osteolysis were absent. No patient had to be revised.

scholarly journals Good mid-term results with the trident peripheral self-locking cup: a clinical evaluation and migration measurement with EBRA

2020 ◽  
Author(s):  
Dietmar Dammerer ◽  
Philipp Blum ◽  
David Putzer ◽  
Andreas Tscholl ◽  
Michael C. Liebensteiner ◽  
...  
Keyword(s):  
Trial Registration ◽  
Inclusion Criteria ◽  
Acetabular Cup ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Press Fit ◽  
Medical Histories ◽  
Migration Analysis ◽  
Radiological Analysis

Abstract Introduction The most common cause of failure in total hip arthroplasty (THA) is aseptic loosening. Uncemented cup migration analysis by means of Einzel–Bild–Roentgen–Analyse (EBRA) has shown to be a good predictive indicator for early implant failure if the cup migrates more than 2 mm within 4 years after surgery. In this study, we performed a migration analysis of an uncemented peripheral self-locking (PSL) press-fit cup after 4 years follow-up. Materials and methods We retrospectively reviewed all patients who received a trident PSL press-fit cup at our department between 2004 and 2017. A total of 636 patients were identified. As inclusion criteria for radiological analysis, a minimum follow-up of 2 years was defined. We reviewed medical histories and performed radiological analysis using EBRA software. EBRA measurements and statistical investigations were performed by two independent investigators. Results A total of 149 cups in 146 patients (female 82; male 64) met our inclusion criteria. Mean age at surgery was 65 years (33–89). We found a significant improvement in the WOMAC score pre- to postoperative (p < 0.0001). EBRA migration analysis showed a mean total migration of 0.6 mm (0.0–8.2) over our follow-up period of 4 years. Of the investigated cups, 69.8% showed a migration rate smaller than 2 mm in the investigated follow-up. Conclusion The acetabular cup used in our study provides low migration at final follow-up. Therefore, a good long-term outcome can be expected for the PSL cup. Trial registration Trial registration number is 20181024-1875 and date of registration is 2018-10-24.

Migration characteristics and early clinical results of a novel-finned press-fit acetabular cup

2014 ◽  
Vol 126 (7-8) ◽  
pp. 208-211 ◽  
Author(s):  
Martin Kaipel ◽  
Anton Prenner ◽  
Sebastian Bachl ◽  
Sebastian Farr ◽  
Günter Sinz
Keyword(s):  
Clinical Results ◽  
Acetabular Cup ◽  
Press Fit

Anchorage of Wrist Joint Prostheses to Bone Using the Osseointegration Principle

1997 ◽  
Vol 22 (1) ◽  
pp. 84-89 ◽  
Author(s):  
G. LUNDBORG ◽  
P. I. BRÅNEMARK
Keyword(s):  
Wrist Joint ◽  
Clinical Results ◽  
Joint Arthroplasty ◽  
Artificial Joint ◽  
Range Of Movement ◽  
Titanium Screws ◽  
Joint Mechanism ◽  
Joint Prostheses ◽  
Observation Period

Five patients with rheumatoid arthritis (age 28–60 years) underwent wrist joint arthroplasty with individually designed artificial joint mechanisms, anchored to bone using the osseointegration principle. We report on the result from a 4 to 6.5 year follow-up with special emphasis on the fixation of the prosthesis to bone. There was no bone resorption or loosening of screws. Osseointegration of the titanium screws occurred in all cases and persisted throughout the observation period, although scattered lytic zones could sometimes be seen around the screws. The clinical results were satisfactory with pain relief and maintenance of a functional range of movement. The principle has prospects for fixation of a wrist joint mechanism to bone, although the presently used joint mechanism requires further refinement.

scholarly journals Application of a novel shape-memory alloy concentrator in displaced olecranon fractures: a report of the technique and mid-term clinical results

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Demeng Xia ◽  
Panyu Zhou ◽  
Lei Li ◽  
Yan Xia ◽  
Zichen Hao ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Shape Memory Alloy ◽  
Shape Memory ◽  
Clinical Results ◽  
Olecranon Fracture ◽  
Surgical Approaches ◽  
Dash Score ◽  
The Mean ◽  
Olecranon Fractures

Abstract Purpose Olecranon fracture is a common upper limb fracture, and several surgical approaches have been advocated for its fixation. To overcome the complications associated with common techniques, we present a novel shape-memory alloy concentrator, an alternative for tension band compression, to fix olecranon fracture. Methods Fifty-seven patients (26 men and 31 women) with olecranon fracture, with a mean age of 45 years, were included in this study. Each patient had undergone open reduction and internal fixation using the Nitinol (Ni-Ti) arched shape-memory connector (ASC). The clinical assessments were performed using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Mayo Elbow Performance (MEP) score, which were both recorded at the final follow-up visit. Results The patients were followed up for 44 months on average (range, 31 to 56 months). No patients were lost to follow-up, and all of the olecranon fractures healed in an average of 15 weeks (range, 10 to 34 weeks). The mean DASH score was 8.6 (range, 0 to 32.4), and the mean MEP score was 92.5 (range, 74 to 100). Nine patients showed postoperative complications: prominent hardware (2), infection (1), loss of the range of functional motion (5), and heterotopic ossification (1). Conclusion The ASC may serve as a favorable device for multi-fragmented and comminuted fractures with rare hardware irritation and may also provide continuous concentrative compression to accelerate osseous healing, thereby aiding the restoration and permitting an early rehabilitation with a low incidence of postoperative complications.

Is the RM- Uncemented Coated Acetabular Cup a Reliable Component in Total Hip Replacement?

1993 ◽  
Vol 3 (3-4) ◽  
pp. 75-83
Author(s):  
A. Avai ◽  
M. Bombelli
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Clinical Results ◽  
Acetabular Cup ◽  
Proper Position ◽  
Total Hip ◽  
Bone Reaction

From August 1987 to the Ist of March 1993 1,477 RM.-isoelastic, uncemented cup components (257 HA, 1,220 Titanium coated) were inserted for T.H.R., matched with the RM- isoelastic and isotitan stem components. At a 4 year mean follow-up (7-1 years) 1,302 cups were clinically and radiographically assessed; 6.2% of cups could not be controlled, because at follow-up time the patients had died; 5.6% could not be traced. All the cups were fixed with 3.2 mm peripheral screws (mean number of screws: 6). The cups more than 60 mm in diameter were fixed with 2 additional cancellous (6.5 mm) screws. The Charnley score is: - 9 - (97.5%) - 8- (2.43%); 1 cup was removed because of infection (0.07%); 3 cups were revised because of malposition and reinserted in proper position. The results with a similar number of RM.-uncoated cups, fixed with only one or two screws from 1979 to 1985, at a mean 4 year follow-up were: 7% revision and 9% impending loosening. Even bone reaction at the bone-cup interface signifies no osteolisis, neither around the cup nor around the screws. The satisfactory clinical results suggest to proceed with the use of this cup

scholarly journals Early Term Radiographic Follow-Up of the Trident Tritanium Acetabular Component

2021 ◽  
Vol 11 ◽  
Author(s):  
David DeBoer ◽  
Jeffrey Hodrick ◽  
Matthew Christie
Keyword(s):  
Acetabular Component ◽  
Radiolucent Line ◽  
Clinical Results ◽  
Acetabular Cup ◽  
Single Institution ◽  
Radiolucent Lines ◽  
Radiographic Outcomes ◽  
Therapeutic Study ◽  
Primary Total Hip Arthroplasty

INTRODUCTION: The purpose of this study was to evaluate the two year clinical and radiographic outcomes of patients undergoing a primary total hip arthroplasty (THA) using the Trident Tritanium primary Cup.   METHODS: 197 patients who underwent a direct anterior THA using a Tritanium acetabular component between 2011 and 2015 were retrospectively reviewed by two surgeons from a single institution. The investigators, along with an independent physician, separately reviewed radiographs blinded to clinical data looking for radiolucent lines adjacent to the acetabular cup using the Charnley-DeLee zones. Clinical results were measured using acetabular revision surgery as an end point for failure. According to the American Academy of Orthopaedic Surgeons Levels of Evidence, this study was consistent with a Level III Therapeutic study.   RESULTS: 101 (48.73%) subjects did not exhibit any radiolucent lines around the acetabular component. 53 (26.90%) subjects displayed radiolucency in only one zone. 27 (13.71%) subjects displayed radiolucency in two zones, and 16 (8.12%) displayed radiolucency in all three zones. Radiolucency was most prevalent in zone 1 at 2 years with 83 (42.13%) subjects displaying radiolucency. There were five (2.54%) acetabular failures within two years of the index surgery. Of those 5 subjects, 3 displayed radiolucency in 1 zone, 2 displayed radiolucency in >1 zone, and 2 displayed radiolucencies >1 mm.   CONCLUSION: In our study, the Tritanium Cup demonstrated a 2.54% failure rate for aseptic loosening at 2 year follow-up. In addition, 48.73% of patients displayed a radiolucent line in at least one Charnley-DeLee zone. We also observed a progression of radiolucencies between the 6 month radiographs and the 2 year radiographs.

Clinical outcomes and complications after pedicle subtraction osteotomy for correction of thoracolumbar kyphosis

2007 ◽  
Vol 6 (4) ◽  
pp. 330-336 ◽  
Author(s):  
Minoru Ikenaga ◽  
Jitsuhiko Shikata ◽  
Mitsuru Takemoto ◽  
Chiaki Tanaka
Keyword(s):  
Postoperative Complications ◽  
Clinical Outcomes ◽  
Late Onset ◽  
Intraoperative Complications ◽  
Clinical Results ◽  
Pedicle Subtraction Osteotomy ◽  
Plumb Line ◽  
Adjacent Segment ◽  
Thoracolumbar Kyphosis

Object Many patient complications have been reported after the use of the pedicle subtraction osteotomy (PSO) technique. To the authors' knowledge, no previous reseachers have reported on the causes of complications after using the single-stage PSO technique with a posterior approach. The purpose of this study was to investigate complications after the procedure, to clarify the factors influencing the complications, and to identify ways to minimize complications. Methods Records for 67 patients treated with the PSO technique were examined retrospectively. All complications were recorded and analyzed in relation to the radiological and clinical outcomes. No patient died or became paraplegic as a result of surgery. There were 48 surgery-related complications in 27 patients (40%): six intraoperative, four perioperative, and 38 late-onset postoperative complications. As the study progressed and more patients were treated, the rate of intraoperative complications decreased significantly. The incidence of late-onset complications associated with an adjacent-segment progression of kyphosis was lower in patients with a long fusion from a midthoracic vertebra to the sacrum or pelvis than in patients treated with a shorter fusion. The C-7 plumb line values and postoperative complications were closely correlated with clinical results. Conclusions Intraoperative complications can be prevented or the risks minimized with adequate surgical training. Most of the late-onset complications in these patients were related to the progression of kyphosis. The frequency of complications was closely correlated with patient satisfaction at follow up. Correcting the C-7 plumb line value with minimal complications appeared to lead to better clinical results.

scholarly journals Long-term outcome of cementless total hip arthroplasty with threaded Tropic® acetabular cup and Corail® femoral stem

2021 ◽  
Vol 87 (3) ◽  
pp. 393-399
Author(s):  
Fernando Almeida ◽  
Silvia Gállego ◽  
Francisco Argüelles ◽  
Antonio Silvestre
Keyword(s):  
Polyethylene Wear ◽  
Femoral Stem ◽  
Acetabular Cup ◽  
Survivorship Analysis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Press Fit ◽  
Clinical And Radiological Results ◽  
Pelvic Osteolysis

This study investigates the clinical and radiological results of a tapered femoral stem (Corail®) and uncemented threaded acetabular cups (Tropic®) and in addition an analysis of the complications and retrieved implants was conducted. Between January 1990 and September 1998, 301 total hips arthroplasties in 268 patients were implanted. 78 patients (87 hips) had died and 9 patients (12 hips) had been lost to follow-up, leaving at the time of the latest follow-up 180 patients (202 hips). The mean age at surgery was 56,1 (27-75) years. Of the 154 unrevised hips, the median Harris and Merle d´Aubigne and Postel hip scores were 83,3 points and 15,3 points respectively at the latest follow-up. The median follow-up time was 16.9 years (10,4-25). No femoral component was revised for aseptic loosening ; osteolysis was observed in the 9,5% of the implants (13 stems). 48 hips (23%) were revised and 27 cups (56,2%) needed revision surgery because of massive polyethylene wear. Pelvic osteolysis was found out in 80 cups (58,8%). 87 hips (63,9%) showed signs of a progressive wear of the liner, more than 2mm in 48 hips. Kaplan-Meier survivorship analysis at 15 years follow-up was 81.2% with revision for any reason (85.8% for mechanical or radiographic loosening). High rates of polyethylene wear and the high prevalence of pelvic osteolysis are serious matters in these types of implants with high rates of revision at 15 years follow-up so we decided to abandon the concept of a threaded cup design in favor of a press-fit acetabular cup.

Early clinical results of intraoperative radiation therapy (IORT) during breast conservation using an electronic brachytherapy (EBX) technique.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 83-83
Author(s):  
V. Elayne Arterbery ◽  
Pamela Johnson
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Postoperative Complications ◽  
Breast Conservation ◽  
Clinical Results ◽  
Cosmetic Outcome ◽  
Intraoperative Radiation Therapy ◽  
Intraoperative Radiation ◽  
Electronic Brachytherapy

83 Background: Intraoperative radiation therapy (IORT) as an alternative to whole breast irradiation (WBI) has been described for patients with early-stage breast cancer. The randomized phase III TARGiT trial demonstrated similar recurrence rates to WBI and a lower overall toxicity profile. IORT-related effects and early postoperative outcome were assessed. We report our clinical experience using a 50 Kv EBX HDR radiotherapy delivery system using a balloon technique. We assessed institutional postoperative complications, clinical outcome and histological findings in patients undergoing IORT for breast cancer on a physician sponsored study. Methods: 22 patients (median age 71 years, negative LN and tumor less than 3 cm) underwent lumpectomy, sentinel lymph node (SLN) biopsy, and concurrent IORT from December 2010 to January 2013. 18 were treated on the study and 4 refused enrollment and elected to be treated off protocol. Patients received IORT (20 Gy) during breast conserving surgery using an EBX technique. WBI was added according to clinical guidelines. Cosmetic results and quality of life were evaluated. Results: Postoperative complications and toxicity was rare without grade 3/4 toxicities. The most frequent postoperative side effects were palpable seroma (8.3%). Erythema grade 1-2 of the breast was found in (13%); whereas in some (3.4%), mastitis. In 80% of the cases patient had IFDCA, the remainder DCIS and tumor size ranged between 0.7 and 2.6 cm (median = 1.0cm). At median 1 year follow-up, no patient suffered a local recurrence. Cosmetic outcome was perceived excellent in most patients and 100% would recommend the procedure. One patient required WBI due to close margins at re-excision. No patient had positive SLN on final path. Conclusions: IORT using electronic brachytherapy as part of breast conservation is safe. The potential advantages of IORT are minimal time needed for cellular repopulation between surgery and radiation treatment, cosmetic outcome and significant logistical advantages and reduced cost. Careful surgical assessment minimizes the need for WBI. Longer follow-up will determine clinical results for cosmetic outcome and local control.

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